What could be achieved? Considering tummy tuck for cosmetic & medical reasons (Photos)

In general for a tummy tuck you want your BMI to be around 30. Calculate yours and see how much you need to loose to get close to that. This will ensure you heal well and have minimal complications. You would be a great candidate for this procedure since you have significant diastasis of the rectus muscles which will be plicated and you have significant lower abdominal skin excess.

Thank you for the photos. A tummy tuck addresses all these problems- the loose skin (the part hanging forward but often even more skin is removed), the excess fat of the midsection and flanks, and the abdominal muscle/fascial separation and stretching are all repaired, resulting in restoring your abdominal core. You are set up perfectly for this operation.

Tummy tuck contours the abdomen.
It removes loose skin, including loose hanging skin that I see in your photo.
The second thing it does is it tightens the abdominal muscles. This helps strengthen and flatten the abdomen.
Finally, liposuction can be used to help contour the area by reducing bulges of fat.
The two goals (appearance and discomfort) you stated in your question are both addressed by this surgery. It is difficult to exercise with the loose skin you show, and it is even difficult getting dressed so I'm sure you will feel much more comfortable with a good tummy tuck.
I recommend you see a surgeon for a consultation to learn more about how this surgery can help you and whether you are a good candidate now or can adjust anything about your health to make you a better candidate.

Hello and thank you for your questions and your photos. Although an in-person consultation and examination will provide more specific information and guide the treatment plan, it seems that you would benefit from a drainless tummy tuck. This procedure will address your concerns for the loose skin, the extra weight and heaviness, and will help repair any separation of your abdominal muscles. Added benefits include better quality of life, easier garment and clothing selection and fitting, as well as better posture and exercise ability.

Best wishes!

Abdominoplasty is a great procedure for removing extra skin for people who are at their ideal body weight. With abdominoplasty, you can expect for the overhang of skin that you have along your lower abdomen to be removed. The upper abdomen will not change much. I would recommend attempting weight loss prior to abdominoplasty to achieve the best result.